You must print this document, fill it out with blue or black ink only. ONLY FILL OUT THE TOP PORTION. Do Not write below the line that says NC Division of Motor Vehicles Use Only.

If you cannot print this form, it will be available at the eye check but you must have a parent with you to sign the form.

Every line on the top part must be filled in, the student must sign where it says student signature and make sure it is easily readable. Parent must also sign. DMV will not check your eyes if this form is not filled out properly and they are not currently doing eye exams at the DMV. Without this form, we cannot call you for your six hours behind the wheel driving.

Click here for the Eye Sheet

2024 Eye Sheet